X0306 4 2016-09-30 1 0001507881 USMD Holdings, Inc. USMD 0001556888 Brock Steven 1211 GREENBRIAR LANE ARLINGTON TX 76013 1 0 0 0 Common Stock ($.01 par value) 2016-09-30 4 D 0 19114 D 0 D Common Stock ($.01 par value) 2016-09-30 4 D 0 39198 D 0 I Indirectly held through UANT Ventures, L.P. 5% Convertible Subordinated Notes Due 2019 10.61 2016-09-30 4 D 0 5750 0.00 D 2014-09-01 Common Stock ($.01 par) 5750 0 I Indirectly held trhoguh AOB Surgical Group, Ltd. Disposed of at the effective time of the merger of Project Z Merger Sub, Inc. ("Merger Sub"), a wholly-owned subsidiary of WellMed Medical Management, Inc. ("WellMed") with and into the issuer (the "Merger"), pursuant to that certain Agreement and Plan of Merger dated August 29, 2016, among the issuer, WellMed and Merger Sub, in exchange for a cash payment of $22.34 per share. Upon its disposition of its shares of the issuer's common stock at the effective time of the Merger, UANT Ventures, L.P. ("Ventures") received a cash payment of $22.34 per share. After paying certain Merger-related costs, each partner of Ventures, including the reporting person, received a distribution equal to $22.22 per share (subject to certain post-closing adjustments) for the shares of the issuer's common stock such person held indirectly through Ventures. The noteholder had the right at any time after April 29, 2016 but prior to the payment in full of the note by the issuer, to convert all or any portion of the unpaid principal balance of the note into shares of the issuer's common stock. The note was repaid in full in connection with the Merger and this conversion right was cancelled. /s/ Steven Brock 2016-10-04